Sehmbi Herman, Retter Susanne, Shah Ushma J, Nguyen Derek, Martin Janet, Uppal Vishal
Department of Anesthesia & Perioperative Medicine, London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
Department of Anesthesia, Perioperative Medicine and Pain Management, Dalhousie University, Nova Scotia Health Authority and IWK Health Centre, Halifax, NS, Canada.
Br J Anaesth. 2023 Mar;130(3):272-286. doi: 10.1016/j.bja.2022.08.042. Epub 2022 Nov 18.
Network meta-analyses (NMAs) combine direct and indirect estimates to provide mixed (or network) estimates of effect sizes. The scientific rigour of the conduct and reporting of anaesthesia NMAs is unknown. This review assessed the epidemiological, methodological, and statistical characteristics of anaesthesia NMAs.
We searched four databases for anaesthesia NMAs and developed a 64-item checklist to evaluate NMAs. For 29 binary items, we defined compliance as 'the ratio of NMAs that was awarded a 'yes' for that item, divided by the total number of NMAs. The compliance of such binary items was reclassified as very low (≤25%), low (26-50%), fair (51-75%), and high (>75%). We amalgamated findings from 29 key items to provide specific recommendations (post hoc). We compared the compliance of NMAs in anaesthesia across 26 items, with that of cancer NMAs and Cochrane NMAs, and analysed improvement over time (post hoc).
Among 62 included NMAs, compliance was low (26-50%) for protocol registration, use of PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for NMA), publication bias assessment, evidence appraisal, reporting of Bayesian methodology and consistency evaluation. Compliance was very low (≤25%) for bias assessment, biostatistician involvement, search specialist, and use of predefined important differences.
Anaesthesia NMAs need improvement in their conduct and reporting. Anaesthesia journals should mandate the registration of protocols and reporting of NMAs using PRISMA-NMA. Authors should carefully assess publication bias, and use updated bias assessment tools, and evidence appraisal methods designed for NMAs.
PROSPERO CRD42021227608.
网状Meta分析（NMA）结合直接和间接估计值，以提供效应量的混合（或网状）估计值。麻醉NMA开展及报告的科学严谨性尚不清楚。本综述评估了麻醉NMA的流行病学、方法学和统计学特征。
我们在四个数据库中检索麻醉NMA，并制定了一份包含64项条目的清单来评估NMA。对于29个二元条目，我们将依从性定义为“该条目被评为‘是’的NMA数量与NMA总数之比”。此类二元条目的依从性被重新分类为极低（≤25%）、低（26 - 50%）、中等（51 - 75%）和高（>75%）。我们合并了29个关键条目的结果以提供具体建议（事后分析）。我们比较了26个条目中麻醉NMA与癌症NMA和Cochrane NMA的依从性，并分析了随时间的改善情况（事后分析）。
在纳入的62项NMA中，方案注册、使用PRISMA - NMA（网状Meta分析的系统评价和Meta分析的首选报告项目）、发表偏倚评估、证据评估以及贝叶斯方法报告和一致性评估的依从性较低（26 - 50%）。偏倚评估、生物统计学家参与、检索专家以及使用预定义的重要差异的依从性极低（≤25%）。
麻醉NMA在开展和报告方面需要改进。麻醉学杂志应强制要求方案注册，并使用PRISMA - NMA报告NMA。作者应仔细评估发表偏倚，并使用更新的偏倚评估工具以及为NMA设计的证据评估方法。
PROSPERO CRD42021227608。
